CMS Price Transparency Data

Drug screening test

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: G0480 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G0480
Insurance Median: $127
Cash Discount Price: $100
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Drug screening test at Intermountain Health Sanpete Valley Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $114.43, this hospital’s rate is 1.11x the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$114.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $114.43 (100%)

Cash / Self-Pay: $100 (87%)

Insurance Median: $127 (111%)

Cash: $100 (87% of Medicare)

Ins. Median: $127 (111% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $114.43 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Molina	$36 - $127	31%
Health Plan of Nevada	$36 - $119	31%
Selecthealth	$36 - $127	31%
Blue Cross Blue Shield	$40 - $127	35%
American Health	$40 - $119	35%
Humana	$40 - $127	35%
UnitedHealthcare	$40 - $127	35%
Aetna	$40 - $129	35%
Health Partners of Nevada	$40 - $114	35%
Healthy U	$40 - $119	35%
Triwest	$42 - $121	37%
Injury Care of Nevada	$100	87%
Byu Risk Management	$114	100%
Wcf Insurance	$114	100%
Corvel Corporation	$114	100%
Corporation of the President	$114	100%
Hygeia Corporation	$127	111%
Global Excel	$127	111%
Awh Connected	$127 - $129	111%
Utah Tech	$127	111%
Motivhealth	$127	111%
Campbell Scientific	$127	111%
Ifit	$127	111%
Cigna	$127	111%
Springtide	$127	111%
Tanner LLC	$127	111%
Emi Health	$127	111%
Uofu	$127	111%
Emi	$127	111%
Medcare International	$127	111%
Health Utah	$127	111%
Lw Miller	$127	111%
Managed Care Admin	$127	111%
Byu Athletics	$127	111%
Wise Network	$127	111%
Deseret Mutual	$127	111%
Franklin County	$127	111%
Pehp	$127	111%
Juniper Systems	$127	111%
Prodegi Corp Benefit	$127	111%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $100.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G0480.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Intermountain Health Sanpete Valley Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G0480.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.